<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<title>S&amp;I Framework - Scenarios: Sending a Patient Follow-up Care Instructions</title>
	
<link rel="stylesheet" type="text/css" href="css/main.css"/>
</head>

<body>

<div class="container">
  <div class="header">
  <div class="navglobal">
                    <ul>
                        <li>S&amp;I Framework Links:</li>
                        <li><a href="http://www.siframework.org" target="_self">Home</a></li>
                        <li><a href="http://wiki.siframework.org/" target="_new">Wiki</a></li>
                        <li><a href="http://sibrowser.siframework.org/" target="_new">Repository Browser</a></li>
                        <li><a href="http://pilots.siframework.org/" target="_new">Pilots</a></li>
                    </ul>
                </div>
                <div class="banner">
  <a href="index.html"><img src="images/onc_si_logo.png" alt="S&amp;I Framework" width="417" height="36" id="onc_si_logo" /></a>  
  </div></div>
  <!-- end .header -->
  <!-- begin .nav1 -->
  <div class="nav1">
  	<ul class="nav">
      <li><a href="index.html">Home</a></li>
      <li><a href="whatis.html">What is the S&amp;I Framework?</a></li>
      <li><a href="getinvolved.html">How Do I Get Involved?</a></li>
      <li><a href="accomplishments.html">What Have We Accomplished?</a></li>
      <li><a href="implementation.html" class="active">How Do I Implement?</a></li>
      <li><a href="contact.html">Contact Us</a></li>
    </ul>
  </div>
  <!-- end .nav1 -->
  <div class="banner_main">
<img src="images/banner_implementation_scenarios.png" alt="S&amp;I Scenarios" />
	
</div>
  <!-- begin .middle -->
  <div class="middle">
    <!-- begin .content .nosblt (no sidebar on left) -->
    <div class="content nosblt">
      <h4 class="scenarios"><a href="implementation.html" class="blue">NwHIN 1.0 Portfolio</a> > <a href="scenarios.html" class="blue">Scenarios</a> > <a href="scenario_qh.html" class="blue">Sending a Patient Follow-up Care Instructions</a></h4>
      <h1 class="testimonials">Sending a Patient Follow-up Care Instructions</h1>
      <h6>A rehabilitation patient accesses her follow-up instructions via a patient portal:</h6>
      <div class="scenario_center"><p><img src="images/scenario_QH.png" alt="S&amp;I Functions" title="A flow diagram illustrating the transfer of follow-up care instructions from a physical therapist to a patient via Direct. The physical therapist sends instructions to the patient's Direct address. The message passes through the physician’s HISP, is encrypted and sent to the hospital's HISP. The hospital's HISP decrypts the message & routes it to the patient’s Direct address via a Patient Portal. An automated email is sent to the patient notifying her of a new secure message in her Patient Portal.
"/></p></div>
      <p>A patient is seen by an orthopedic surgeon at her local hospital and undergoes knee surgery.  As part of registering for the hospital&rsquo;s Patient Portal, the patient is issued a Direct address at the hospital, which she can access from the Patient Portal.</p>
      <p>While undergoing rehabilitation from the surgery, she regularly sees a physical therapist at a local outpatient clinic. Instead of sending the patient home with follow-up care instructions on printed paper, the physical therapist sends these documents to her Direct address (provided by the local hospital). The Patient Portal sends a notification email to the patient&rsquo;s personal email address, indicating that a new secure message has arrived at her Direct address.  The patient logs onto the Patient Portal, from which she can retrieve the new Direct message, and view and download the follow-up care instructions.</p>
<div class="mu">
<table width="100%" border="0" cellspacing="0" cellpadding="0">
       <tr>
         <td width="40" align="left" valign="top"> <img src="images/clipboard_check.png" alt="Meaningful Use Objectives" /> </td>
         <td width="15">&nbsp;</td>
         <td valign="middle"><p class="mu"><strong>Meaningful Use Stage 2 Objectives related to delivery of health information to patients:</strong> Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP. (<em>Meaningful Use Menu Set 7 for EPs, Meaningful Use Menu Set 6 or EH/CAHs</em>)</p></td></tr></table>
</div>
<br />
     <h6>Common workflow steps for this scenario:</h6>
     <div class="table_scenario1">
     <table width="946" border="0" cellspacing="0" cellpadding="0">
       <tr>
         <td width="40" align="left" valign="top"> <img src="images/scenario_1.png" alt="1" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The physical therapist uses his Direct account to author a message to the patient.  He specifies the Direct address the patient provided as the &ldquo;recipient&rdquo; for the message, and attaches the follow-up care instructions.</td>
       </tr>
       <tr>
         <td height="15" align="left" valign="top">&nbsp;</td>
         <td height="15">&nbsp;</td>
         <td height="15" valign="middle">&nbsp;</td>
       </tr>
       <tr>
         <td width="40" align="left" valign="top"> <img src="images/scenario_2.png" alt="2" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">When the physical therapist sends the message, it passes through the physical therapist&rsquo;s Health Information Service Provider (HISP), a contracted brokering agent responsible for the management of security and transport for directed exchange. As it passes through the HISP, the message is encrypted using the x.509 Certificate associated with the patient&rsquo;s Direct address, and delivered to the patient&rsquo;s Direct address at the local hospital in accordance with the Applicability Statement for Secure Health Transport.</td>
       </tr>
       <tr>
         <td height="15" align="left" valign="top">&nbsp;</td>
         <td height="15">&nbsp;</td>
         <td height="15" valign="middle">&nbsp;</td>
       </tr>
       <tr>
         <td width="40" align="left" valign="top"><img src="images/scenario_3.png" alt="3" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">When the message is received at the patient&rsquo;s Direct address by the hospital&rsquo;s HISP, an automated email notification is sent from the patient portal to the patient&rsquo;s personal, non-Direct email address alerting her of the new secure message that awaits on the Patient Portal.</td>
       </tr>
       <tr>
         <td height="15" align="left" valign="top">&nbsp;</td>
         <td height="15">&nbsp;</td>
         <td height="15" valign="middle">&nbsp;</td>
       </tr>
       <tr>
         <td width="40" align="left" valign="top"><img src="images/scenario_4.png" alt="4" /></td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">When the patient logs into the Patient Portal, she accesses the content in her Direct inbox, and downloads the follow-up care instructions that were sent by the physical therapist.</td>
       </tr>
     </table>
</div>
      <br />
      <h6>NwHIN 1.0 specifications and resources recommended for scenario:</h6>
 <div class="table_scenario2">     
<table width="956" border="0" cellspacing="10" cellpadding="10">
  <tr>
    <td width="300" align="left" valign="top" bgcolor="#BF311A">
      <h4 class="scenario2">Transport and Security</h4>
        Mechanisms and processes that safely exchange health information over the Internet
      </td>
    <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
      <li><a href="http://wiki.directproject.org/Applicability+Statement+for+Secure+Health+Transport" target="_new">Applicability Statement for Secure Health Transport</a></li>
      <li><a href="http://tools.ietf.org/html/rfc5280" target="_new">x.509 for Certificates</a></li></ul></td>
  </tr>
</table></div>

      <p>&nbsp;</p>
</div>
    <!-- end .content .nosblt -->
  </div>
  <!-- end .middle -->
  <!-- begin .footer -->
  <div class="footer">
    <p>&nbsp;</p>
  </div>
  <!-- end .footer -->
</div>
<!-- end .container -->
</body>
</html>
